Healthcare Provider Details

I. General information

NPI: 1194514166
Provider Name (Legal Business Name): FAITHPOINT WELLNESS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9195 HIGHWAY 57
COUNCE TN
38326-3751
US

IV. Provider business mailing address

9195 HIGHWAY 57
COUNCE TN
38326-3751
US

V. Phone/Fax

Practice location:
  • Phone: 731-925-1778
  • Fax: 731-438-3168
Mailing address:
  • Phone: 731-925-1778
  • Fax: 731-438-3168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AMY B MITCHELL
Title or Position: OWNER
Credential: NP
Phone: 731-925-1778